Slipped capital femoral epiphysis

A slipped capital femoral epiphysis occurs when the upper end of the thigh bone (femur) slips at the area where the bone is growing (growth plate or physis) and does not fit in the hip socket correctly. The condition is most common in young teenagers. It's more common in boys than in girls.

Symptoms usually begin between ages 10 and 16 years. They may begin earlier in girls than in boys. Symptoms vary in severity and speed of progression. Symptoms may include:

• Hip tenderness or pain and decreased movement during the early stages of the condition.
• Increased pain when the toes are turned in toward midline (internal rotation of the hip).
• Mild discomfort in the groin, thigh, or knee while walking or running. Rest relieves this discomfort.
• Knee pain. Sometimes knee pain is the first symptom.
• Stiffness and a limp, especially when tired.
• Muscle spasms.
• Mild to severe pain.

Your doctor will conduct a medical history to learn how long you have had your symptoms and a physical exam to identify your symptoms. X-rays and sometimes CT scan or MRI are used to confirm a diagnosis of slipped capital femoral epiphysis.

The goal of treatment for a slipped capital femoral epiphysis is to prevent further slippage, restore the normal position of the bones, and reduce complications of the condition. This often involves surgery to secure the growth plate (physis) with a single screw or with pins. Osteotomy may be used in a severe case, but this is rare. In an osteotomy, the doctor cuts the bone at the top of the leg near the hip joint, moves the bone to a more normal position, then uses metal pins to hold it in place. The pins are usually left in the bone after it heals.

Crutches may be used to take weight off the hip. Before surgery, this prevents further slippage and helps reduce pain. After surgery, using crutches reduces pain and helps keep the hip stable and in good position as it heals.

A slipped capital femoral epiphysis may lead to early degenerative arthritis of the hip if it is not detected early and treated properly.

• Give pain medicines exactly as directed.
  • If the doctor gave your child a prescription medicine for pain, give it to your child as prescribed. Call your doctor if you think your child is having a problem with the medicine.
  • If your child is not taking a prescription pain medicine, give your child an over-the-counter medicine such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Be safe with medicines. Read and follow all instructions on the label. Do not give ibuprofen to a child who is younger than 6 months.
  • Do not give two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Follow your doctor's directions for activity.
• Have your child use crutches as your doctor directs.